Organ and tissue donation is more important than many of us realize—for society and for the individuals it directly affects. Today, there are nearly 118,000 individuals waiting for an organ transplant to live healthier, more productive lives (Unpublished data, Organ Procurement and Transplantation Network [OPTN], April 2013). For some people with end-stage organ failure, it is truly a matter of life and death. Add to these the thousands more whose lives will be improved through tissue and cornea donation and transplants that can help them move better, see better, and live better.
Donation affects more than the donors and recipients. It also affects the families, friends, colleagues, and acquaintances who love and support those in need of transplantation, and who benefit from their renewed life and improved health after transplant. For my part, I have experienced not once, but twice how donation and transplantation affects individuals.
Twenty years ago, my wife, Donna Lee Jones, died in a severe automobile accident. Her death was a shock, and my family did not know what to make of our tragedy. Then we were offered the opportunity to donate her organs and tissues for transplantation. While it did not lessen the pain of her loss, it brought comfort to us knowing that out of our tragedy, some good would come, and others could receive the gift of life. Because of her donation, several people received a new lease on life: a man in Tampa, Florida, received her heart; a teenage boy in Washington, D.C., received a kidney and pancreas; a hospital custodian received her other kidney; a woman in Pennsylvania received her liver; and her corneas went to a young woman in Baltimore, Maryland, and a government worker.
Four years later, my 20-year-old daughter, Vikki Lianne, was struck by a car and died. Losing a spouse was tragic enough, but the pain of losing a child cannot be expressed. Falling back on our previous experience, we decided to donate Vikki’s organs and tissues for transplantation. Again, several individuals benefited from her gift: a mother of five children from Upstate New York received her heart; a widow with four children received her lung; a 59-year-old man from Washington, D.C., who was active with a local charity, received her liver; a widower with one daughter received her kidney; a working father received the other kidney; and her corneas went to a 26-year-old man in Florida and a 60-year-old woman in Pennsylvania. And we, her family, took comfort in the idea that Vikki’s legacy was one of life and giving.
Organ donation provides a life-giving, life-enhancing opportunity to those who are at the end of the line for hope. And the need for organ donors is growing. When Donna Lee died in 1992, there were 27,000 people on the transplant wait list. When Vikki died just four years later, that number had grown to 47,000 (Unpublished data, OPTN, January 2010). As of April 5, 2013, there were 117,812 people waiting, with hope, for an organ to become available (Unpublished data, OPTN, April 2013).
One way to expand the number of organs available for transplantation is to expand the number of donors, through carefully and safely considering individuals who in the past were not included. The guideline in this special issue of Public Health Reports provides a scientific, evidence-based process to assure a balance between organ safety and availability for each individual on the transplant wait list. As our knowledge and scientific capabilities regarding safety and availability grow and evolve, donors who in the past would not have been considered as donors are now able to provide the gift of life to others.
This guideline will help improve organ transplant outcomes, leading to more individuals being able to live healthier and longer lives. The science and evidence are clear and will improve the safety of organs, balanced with a clear and conscious regard for donors and recipients. It is the human aspect of donation and transplantation—helping people. It is the right thing to do.